West Virginia is characterized by its rural and rugged terrain, depressed economy, and poor access to adequate medical services. It is the only state that lies entirely within Appalachia. For those workers who are employed, work is often labor intensive such as that required in underground mining, family farming, timber harvesting and other rural occupations. These factors contribute to an injury fatality rate that exceeds the national rate. As the state's land-grant flagship institution for both research and patient care, West Virginia University (WVU) is committed to improving the health and safety of West Virginians. While significant improvements in emergency medicine, trauma care and injury prevention have occurred over the last 10 years, there remains a critical need for injury research, education, and dissemination activities throughout the state and surrounding region. The mission of the WVU ICRC is to advance the science and practice of injury control through research, education, and information dissemination. Over the next five years, the Center plans to accomplish this mission by pursuing the following Specific Aims: 1) conduct and stimulate interdisciplinary injury control research, with emphasis on injuries affecting high-risk rural populations;2) promote scholarship and leadership in injury control by educating the next generation of WVU graduate students and medical students in the science and practice of injury control;3) Provide accurate and timely information on the health and economic burden imposed by injuries and the effectiveness of preventive interventions through a range of dissemination activities;and 4) maintain an organizational structure that supports our mission and enhances Center growth, quality, and efficiency through an evaluation and review process. Six research projects are proposed: 1) Rural-Urban Differences in Injury Hospitalizations (large, acute care/prevention [AC/P]);2) Development and Evaluation of an Intervention for Intimate Partner Violence in the Context of Nurse Home Visits (large, P);3) The Black-White Suicide Paradox: A Multilevel Multiple Cause-of-Death Evaluation (small, P);4) Understanding the Long-term Consequences of Injury among Older Adults (small, P);4) Adaptive Measures of Family Violence (small, P);and 6) How often do Catastrophic Injury Victims Become Medicaid Recipients? (small, P/AC).